Homestead_MinnisCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
` State Form 5673 (Re 17 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I(We) �—J I Il I,r I "N* l .1/ AlL
I (We) occupied as our principal place of residence the following
y� � FOR YEAR
AJ 11"� ce r 51�,6j�kmAH4*y of March, 20_
real property for which a Homestead Pro /¢efpt /, �f F �ltTig'Rereby claimed:
I (We) owned ❑ Are buying under contract GIBSON C
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT • -. .
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
County
Township
I hereby certify the above statements are true, correct and complete.
County
W 1 ress (number and street cif}; state, and ZIP code)
1 (S Al, Vl-,l C-- S-(• /ti 476 37
Township
ASSESSOR •
Coun
PROPERTY DESCRIPTION
Township Taxing district( y, town, towns p)
Parcel number
a!0-4 9 -31 -3o I — 0.
Legal description
3—
Is the property in question:
I property ❑ Wells Home (IC 6-1.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immedateiy surtounds 'he' structure is used to produce Income, describe ft use and portion
of the property utilized to produce income.
County
Township
I hereby certify the above statements are true, correct and complete.
County
W 1 ress (number and street cif}; state, and ZIP code)
1 (S Al, Vl-,l C-- S-(• /ti 476 37
Township
ASSESSOR •
. VALUE
HOMESTEAD
AT 100% •
VALUE i
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other lands
(2)
YS Kbtt1?�.
Total land (line 1 plus Me 2)
(3)
Dwelling
(4)'�
Residential improvements or Annually
Assessed Motile I Manufactured Home
'^"�.•utr4' �s�. »rye '
Garage
(5)
z
Y
Other improvements
(6)
t i
7e4 ,5
Trial improvements (lure 4 through fine 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed (runlh, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
20_pay 20_
Lesser of 12
Homestead Valuation
or
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 S
43,000 for 2009 pay 2010 40,000 payable after 2012
WALE FORM IONA IC(N71 nrAstinx FORM:171A
nrratwm BY BIBLE BMRU Or MTh:NIA`n.`/ rursmmar Ti!!DFPMMFIT<F LOCAL nOVPtNMrNT FINascEte.-1.1.r-I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple.:are limited to one homestead standani deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than exer for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1314-2009 requires taxpayer:who remise the homestead standard deduction to verify that they are eligible to receise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kepi confidential and can only be accessed by authorized county officials.The Depannmt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead hand.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Minnis, Thomas S/Ann M /r/S Ai 59.
p1)Dnv 111
Llaubstadt IN 47639
3081
Thomas S Minnis X73
115 N-Vi..c Ct 70 2.0.i
HAUBSTADT IN 47639-8122 State Parcel Number Legal Description
Itittlitrr ltllrmtt lIt Itlttltt lItmt lit tlt 1rt 1r 1rrr11t1t1rt r1r11 26-19-31-301-000163-009 013-00263-00 ORIGINAL PLAN 124/125 PT
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
'Owner I First Middle Last
7- HOMAS SNELTON P1 (rfN15
es Address(number and stmt,city,state,and ZIP code) O Same as property address
Po 130X 173 HAvQ5 i TA7 lnl 'f74 39
Spouse First Middle Last
/411N RA A M 11\ 5
Mailing Address(Number and street,city,state,and ZIP code) I] Same as property address
130 / 73 . 1_)-AUn5TAJT) 1NI 40g 37
PART 3:CERTIFICATION - ------ - --
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfidly,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
PART 4:ADDITIONAL INFORMATION